Kaiser RNs’ Message to Public: Be Wary of Insurers Who Limit Access to Hospital, Nursing Care

Kaiser RNs’ Message to Public on Eve of ACA Exchange Signups:Be Wary of Insurers Who Limit Access to Hospital, Nursing CareRallies at Kaiser Hospitals in Oakland, Modesto, Sacramento

On the eve of the opening of insurance signups under the Affordable Care Act, registered nurses will rally outside three Kaiser Permanente hospitals in Northern California Monday with a message for consumers – be wary of enrolling in insurance plans that limit your access to a hospital and to safe nursing care.

Kaiser, say RNs, has been making it harder for patients to be admitted for hospital care when sick or injured and sending patients home or to other settings when they should still be in the hospital. As part of that shift away from hospital care, Kaiser has been reducing RN staffing in its hospitals.

“Our message to the public is if you are choosing an insurance plan under the new ACA health exchanges, insist that your insurance plan guarantees that you and your family are able to get the care you need, including full access to hospitalization and safe nursing care,” said Zenei Cortez, a Kaiser RN and co-president of the California Nurses Association/National Nurses United. The ACA-established health exchanges will be open for business and signups on October 1.

“We’ve seen first hand Kaiser inappropriately discharging patients while they still need care. Patients pay a lot in premiums they deserve to be hospitalized when they need care,” said Kaiser Modesto Nurse Kellie Montoya. “We the nurses are here for them.”

As both an insurance company and a hospital chain, Kaiser can increase its profits by reducing patient services, especially hospital care, while still receiving guaranteed monthly premiums from enrollees. Former Kaiser CEO George Halvorson, wrote the New York Times in a March interview, believes “the way to get costs lower is to move care farther and farther from the hospital setting — and even out of doctors’ offices.”

The ACA, for which Kaiser is a leading industry model, accelerates this trend by providing financial incentives for providers to limit formal hospital admissions and deliver care in outpatient settings, such as clinics or doctor’s offices, or home care.

An additional way Kaiser takes advantage of this provision is by holding patients whose health status suggests they should be in a hospital bed in “clinical decision units,” also known as “observation units” for up to 24 hours and then sent home without being admitted before they are fully recovered.

In Oakland, Sacramento and Modesto alone since January over 2500 incidences of unsafe care have been reported to Kaiser by the nurses.

“As a nurse, I want to provide the kind of care to my patients that I would give to my family. It breaks my heart and makes me angry that at the hospital where I work, patients are being put at risk because Kaiser values money more than lives. One of my friends was in tears because she could not give safe care to a child who had cancer and there was not enough nurses to allow the nurse to check the medication correctly. This is wrong and we will not stand by when our patients need us”, said Katy Roemer a Kaiser Oakland RN.

Cathy Kennedy, a Kaiser Roseville RN cited the example of a nurse colleague with a life threatening illness who was “treated multiple times in the Emergency Department and sent home to be cared for by her family only to return within 24 to 48 hours, weaker and even more fragile than before. It took advocacy of nurse colleagues to ensure that she was admitted to the hospital and received the care that she desperately needed. This is a travesty and our patients have a right to access and appropriate care.”

“These restrictions increase Kaiser profits and help company executives thrive, but it makes it harder for the patients who are paying their premiums to survive with the appropriate care they need,” Cortez said.

As part of its drive to limit hospital care, Kaiser is calling for the elimination of up to 400 RNs from hospital care delivery in Northern and Central California hospitals. Many of those nurses may be eligible for positions in Kaiser outpatient facilities, but, nurses say, expanded outpatient services should never be made at the expense of guaranteeing patients receive hospital care when they need it.

On Monday, Kaiser RNs will also be inviting patients to sign a Patient Bill of Rights Pledge which says, “Our community supports our RNs and their efforts to ensure that we get the hospital care we deserve if we are ill.” For more on the pledge, see http://www.nationalnursesunited.org/pages/ca-kaiser-affiliates.